| Organization Name: | CAL STATE UNIVERSITY FULLERTON |
| NPI Number: | 1013121961 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOWARD WANG (DIRECTOR) |
| Mailing Address: | 800 N State College Blvd Fullerton |
| State: | CA US |
| Postal Code: | 928313547 |
| Phone Number: | 7142782880 |
| Fax Number: | |
| NPI Enumeration Date: | 05/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 244163 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |